National Governors Association Recommends Revisions To Prescription Drug Benefit Implementation

Main Category: Medicare / Medicaid / SCHIP
Article Date: 19 Feb 2007 - 14:00 PDT

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The National Governors Association in a recent letter to HHS Secretary Mike Leavitt recommended that the Bush administration make several revisions to the implementation of the Medicare prescription drug benefit, CQ HealthBeat reports. In the letter -- signed by New Jersey Gov. Jon Corzine (D) and Vermont Gov. Jim Douglas (R), chairs of the NGA health and human services committee -- the group recommended that the Bush administration "adjust the calculation of state contributions for 2007 to be consistent with the intent of the (Medicare drug law) and ensure state contributions reflect the actual cost of the benefit and are phased down over time." NGA also recommended that CMS ensure states receive appropriate reimbursements for costs associated with the implementation of the Medicare prescription drug benefit in January 2006. According to NGA, "We urge you to reimburse states fully for any outstanding claims as quickly as possible, including those claims paid for beneficiaries in State Pharmaceutical Assistance Programs who are not eligible for the low-income subsidy." In addition, NGA recommended that CMS "continue to play a central role" in coordination of coverage for beneficiaries eligible for both Medicare and Medicaid. NGA wrote, "It is necessary that CMS facilitate a better process for coordination of benefits between states and plans. To aid this effort, states should be granted access to Part D claims data."

CMS Response
CMS spokesperson Jeff Nelligan said, "By any measure, the Part D prescription drug program has been a resounding success -- more than 90% of people with Medicare now have coverage for prescription drugs from Part D or another source; these beneficiaries are saving an average of $1,200 a year, the cost of the program is $189 billion less than first projected and satisfaction is consistently 75%" or more (Carey, CQ HealthBeat, 2/13).

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